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原位肝移植术后监护及并发症分析
引用本文:卢安卫,黄东胜,郑树森. 原位肝移植术后监护及并发症分析[J]. 中华器官移植杂志, 2001, 22(5): 288-290
作者姓名:卢安卫  黄东胜  郑树森
作者单位:浙江大学医学院附属第一医院
摘    要:
目的:探讨原位肝移植术后的临床监护及并发症的防治,方法:30例原位肝移植患者术毕即转入重症监护病房(ICU),按预先设定处理方法,对全身重要脏器的功能和症状体征进行监测。结果:30例术后并发症主要有呼吸功能不全,胸腔积液,高血压,心律失常,急性肾功能不全,肺部感染及一过性高血糖,28例移植肝功能恢复正常,4例死于并发症,结论:原位肝移植术后易并发全身各重要脏器及系统的并发症,并发症严重影响了肝移植的成功率。

关 键 词:原位肝移植 术后监护 并发症 防治

The mornitoring and complications after orthotopic liver transplantation-A report of 30 cases
LU Anwei,HUANG Dongsheng,ZHENG Shusen. The mornitoring and complications after orthotopic liver transplantation-A report of 30 cases[J]. Chinese Journal of Organ Transplantation, 2001, 22(5): 288-290
Authors:LU Anwei  HUANG Dongsheng  ZHENG Shusen
Affiliation:LU Anwei,HUANG Dongsheng,ZHENG Shusen. The First Affiliated Hospital of the Medical Colledge of Zhejiang University,Hangzhou 310003,China
Abstract:
Objectives To study the prevention and treatment of complications and the physiological function disorder following orthotopic liver transplantation (OLT). Methods Between Feb. 1999 and Oct. 2000, 30 consecutive patients underwent OLT. After operation, the patients were treated in the light of prospective design. The physiological functions were determined, the symptoms and signs observed and a series of laboratory tests and special check made. Results In the 30 patients, the postoperative complications included: coma ( 16.7% ), pulmonary insufficiency ( 46.7% ), atelectasis ( 6.7% ), dropsy of chest ( 70.0% ), hypertension ( 63.3% ), cardiac arrhythmia ( 33.3% ), primary nonfunction of grafts ( 6.7% ), acute renal insufficiency ( 30.0% ), infections of the lung ( 56.7% ), septicemia ( 13.3% ), acute urinary tract infection ( 10.0% ), acute rejection ( 10.0% ), hypernatremia ( 46.6% ), hyperglycemia ( 70.0% ), abdominal massive hemorrhage ( 33.3% ). No stress ulcer occurred in the patients while pH of gastric juice was controled over 5. Four cases ( 13.3% ) died of complications. Conclusions The majority of failure of OLT was due to complications which occurred after operation; or due to primariry nonfunction of the grafts.
Keywords:Liver transplantation  Custodial care  Postoperative complications
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